Hematopoietic Cell Transplantation Outcomes in Monosomal Karyotype Myeloid Malignancies

Marcelo C. Pasquini, Mei Jie Zhang, Bruno C. Medeiros, Philippe Armand, Zhen Huan Hu, Taiga Nishihori, Mahmoud D. Aljurf, Görgün Akpek, Jean Yves Cahn, Mitchell S. Cairo, Jan Cerny, Edward A. Copelan, Abhinav Deol, César O. Freytes, Robert Peter Gale, Siddhartha Ganguly, Biju George, Vikas Gupta, Gregory A. Hale, Rammurti T. KambleThomas R. Klumpp, Hillard M. Lazarus, Selina M. Luger, Jane L. Liesveld, Mark R. Litzow, David I. Marks, Rodrigo Martino, Maxim Norkin, Richard F. Olsson, Betul Oran, Attaphol Pawarode, Michael A. Pulsipher, Muthalagu Ramanathan, Ran Reshef, Ayman A. Saad, Wael Saber, Bipin N. Savani, Harry C. Schouten, Olle Ringdén, Martin S. Tallman, Geoffrey L. Uy, William A. Wood, Baldeep Wirk, Waleska S. Pérez, Minoo Batiwalla, Daniel J. Weisdorf

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

The presence of monosomal karyotype (MK+) in acute myeloid leukemia (AML) is associated with dismal outcomes. We evaluated the impact of MK+ in AML (MK+AML, n = 240) and in myelodysplastic syndrome (MDS) (MK+MDS, n = 221) on hematopoietic cell transplantation outcomes compared with other cytogenetically defined groups (AML, n = 3360; MDS, n = 1373) as reported to the Center for International Blood and Marrow Transplant Research from 1998 to 2011. MK+ AML was associated with higher disease relapse (hazard ratio, 1.98; P <.01), similar transplantation-related mortality (TRM) (hazard ratio, 1.01; P =90), and worse survival (hazard ratio, 1.67; P <.01) compared with those outcomes for other cytogenetically defined AML. Among patients with MDS, MK+ MDS was associated with higher disease relapse (hazard ratio, 2.39; P <.01), higher TRM (hazard ratio, 1.80; P <.01), and worse survival (HR, 2.02; P <.01). Subset analyses comparing chromosome 7 abnormalities (del7/7q) with or without MK+ demonstrated higher mortality for MK+ disease in for both AML (hazard ratio, 1.72; P <.01) and MDS (hazard ratio, 1.79; P <.01). The strong negative impact of MK+ in myeloid malignancies was observed in all age groups and using either myeloablative or reduced-intensity conditioning regimens. Alternative approaches to mitigate disease relapse in this population are needed.

Original languageEnglish (US)
Pages (from-to)248-257
Number of pages10
JournalBiology of Blood and Marrow Transplantation
Volume22
Issue number2
DOIs
StatePublished - Feb 1 2016

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

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